Jessica Holman starts her Monday by having breakfast and making coffee before 5:45 a.m. It was a restful weekend and she said she feels good. The 36 year old is ready for another week of teaching science to middle-schoolers.
Two hours later, the side effects start to set in.
“I am already out of most of my energy this morning and I’m struggling to stay warm,” Holman said in a voice memo, one of many she recorded throughout a September school day. “I’m also starting to get a little dizzy, which is frustrating because I know I took my medication this morning.”
She makes it through classes, but by 4:30 p.m., Holman is more than ready to end the day. She said she was exhausted and almost too dizzy to drive home.
This is how most days have gone since Holman returned to the classroom. She spent months on disability after contracting the coronavirus in October 2020. The teacher hopes she’ll one day feel better. But for now, she’s one of an unknown number of Americans struggling with long-haul COVID-19.
When the virus is gone but side effects linger
Healthcare providers have learned more about preventing and treating COVID since the pandemic started. But why some patients experience long-lasting symptoms is still mostly a mystery.
Dr. Drew Payne, an internal medicine physician and associate professor at the Texas Tech University Health Sciences Center, said there is not an agreed-upon definition of long-haul COVID. It varies by patient, but symptoms that last for more than four weeks are what concern him.
“But that depends on the severity of illness. It depends on what type of illnesses the patient had before they caught COVID-19,” Payne said. “So that’s why it makes it so difficult to understand which of these symptoms are related to an acute illness, or which are specifically related to COVID-19.”
Fatigue is the most frequent lasting ailment, Payne said. Shortness of breath, coughing and nausea are also common. With earlier strains of the coronavirus, patients often lost their senses of taste and smell that didn’t return for an extended period of time. Payne said that has become a less common side effect as the virus evolves.
For some patients, Payne said pre-existing conditions can play a part in how long symptoms last.
“When they’re hit with a big severe infection, then it’s more likely for them to be affected for a much longer period of time,” the physician said.
However, some patients enduring ailments just don’t make sense to Payne.
“It does become pretty surprising when you get someone who’s healthy in all other aspects of their life, and then they have symptoms that last for a long time,” Payne said.
The number of people struggling with post-COVID conditions is uncertain. At least one study has suggested more than one in four COVID patients have symptoms that last for months. Other research suggests it is happening more frequently.
Jessica Holman’s case is a more puzzling one.
The coronavirus did not make her that sick. When Holman’s oxygen levels dipped, she went to an emergency room. She was told she was not sick enough to be admitted to a hospital as local facilities filled up last fall for what would be a months-long outbreak.
So, she went home and isolated with her boyfriend, Lewis.
“After about two weeks,” Holman said, “my boyfriend got better and I did not.”
Holman began making the rounds at specialists to find out what was happening in her body. She started pulmonary rehabilitation to improve her oxygen levels, which remained low. After months, that improved. Then, Holman got another diagnosis: postural orthostatic tachycardia syndrome, or POTS.
“It basically means that my neurological system was so attacked that it doesn’t understand how to regulate things like my heart rate, my blood pressure,” Holman explained. “Basic things that are kind of important for functioning.”
POTS affects blood flow and can make a person feel lightheaded or dizzy when they stand up. Sitting or lying down helps. Holman now uses a walker with a seat in case she suddenly needs to sit. The syndrome can also cause extreme fatigue.
Extra salt, water and medication can help those with POTS, which most often affects women between the ages of 15 and 50. Since she received a diagnosis, Holman is figuring it all out. She said it is getting easier, most days. Patients with POTS can go into remission.
“It’s also possible it’ll be lifelong and I’ll never get any better,” Holman said. “So it’s one of those things that you just really don’t know.”
Before she contracted COVID-19, Holman lost 150 pounds. She was going for long walks most days and was on a healthier path in life. She said she hopes to get back to that someday.
Have a news tip? Email Sarah Self-Walbrick at firstname.lastname@example.org. Follow her reporting on Twitter @SarahFromTTUPM.